| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 75 WEST TOWNE RIDGE PARKWAY TOWER 2, SUITE 400 SANDY, UT 84070 | REGENCE BLUECROSS BLUESHIELD OF UTAH | $126K | $4K | $130K | 3.61% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 75 WEST TOWNE RIDGE PARKWAY TOWER 2, SUITE 400 SANDY, UT 84070 | LIFEMAP ASSURANCE COMPANY | $16K | $0 | $16K | 3.91% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 75 WEST TOWNE RIDGE PARKWAY TOWER 2, SUITE 400 SANDY, UT 84070 | UPMC HEALTH OPTIONS | $4K | $0 | $4K | 3.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | PO BOX 2158 RIVERSIDE, CA 92516 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $10K | $0 | $10K | 11.52% |
| SPECTRA MANAGEMENT, LLC3 Filed as: SPECTRA MANAGEMENT LLC | 75 WEST TOWNE RIDGE PARKWAY TOWER 2, SUITE 400 SANDY, UT 84070 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $5K | $0 | $5K | 5.80% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL OF CALIFORNIA | 4371 LATHAM STREET, SUITE 101 RIVERSIDE, CA 92501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 10.00% |
| CUSTOM INSURANCE SPECIALISTS INC3 Filed as: CUSTOM INSURANCE SPECIALISTS INC. | 886 EAST 3200 NORTH KAMAS, UT 84036 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $198 | $2K | 9.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICE | PO BOX 2158 RIVERSIDE, CA 92516 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $41 | $2K | 7.56% |
| LESLEE BROOKE GOBELMAN3 Filed as: LESLEE BROOKE GOBLEMAN | 5607 SOUTH GREENLEAF DRIVE MURRAY, UT 84123 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $874 | $96 | $970 | 4.25% |
| JASON SEFITA FANAIKA3 | 1005 NORTH 900 EAST PLEASANT GROVE, UT 84062 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $792 | $0 | $792 | 3.47% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 287 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | REGENCE BLUECROSS BLUESHIELD OF UTAH | 881 | $3.8M |
| Dental | LIFEMAP ASSURANCE COMPANY | 305 | $416K |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 868 | $91K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 196 | $79K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 196 | $79K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 196 | $79K |
| Prescription drug(3 contracts, 3 carriers) | REGENCE BLUECROSS BLUESHIELD OF UTAH | 881 | $3.8M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 196 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 881 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.